Preventing Teen Pregnancy

Fewer teens are getting pregnant in the United States and in the Carolinas, but the battle isn’t over. North Carolina still has the 20th highest teen birth rate in the country, and South Carolina has the 14th.

With research consistently revealing the negative outcomes associated with early childbearing, teen pregnancy has far-reaching consequences. As part of its focus on prevention and early intervention, The Duke Endowment has launched a special program devoted to teen pregnancy prevention. Since June 2016, the Trustees have approved nearly $1.5 million in funding.


Across the country, teen birth rates declined 9 percent in 2014, reaching another record low. After peaking in 1991, the teen birth rate has dropped more than 7 percent annually since 2007.

“Few social issues have improved quite so dramatically over the past 23 years as teen pregnancy and childbearing,” says Sarah Brown, CEO of The National Campaign to Prevent Teen and Unplanned Pregnancy. “The scope of this national success story is truly breathtaking; teen pregnancy and birth rates are at historic lows, declines are geographically widespread, and rates have plummeted among all racial/ethnic groups.”

But despite the gains, teen pregnancy remains far too common among older teens, teens of color, those in rural areas, and those who live in poverty. In addition, the U.S. teen birth rate is much higher compared with other countries.

In South Carolina, 4,297 girls under the age of 20 became mothers in 2014. Seventy-two percent were 18 or 19 years old. Twenty-five percent were already parents.

In North Carolina, 10,328 girls between ages 15-19 were pregnant in 2014. Seventy-three percent were 18 or 19 years old. The repeat pregnancy rate was 22 percent.

Teen mothers are less likely to finish high school (only 38 percent do), and are more likely to live in poverty. According to the National Campaign to Prevent Unplanned Pregnancy, South Carolina spends at least $166 million annually on costs associated with teen childbearing. In North Carolina, teen childbearing costs taxpayers more than $325 million.

“Data show that children of teen mothers are more likely to be born into single-parent homes, more likely to spend their life in poverty, and are much less likely to show up at school ready to learn,” says Forrest Alton, the South Carolina Campaign’s director. “There often are direct consequences to two generations. When children raise children, the odds of future success are not in anyone’s favor.” 

Learn more about teen birth rates in South Carolina.

Learn more about teen birth rates in North Carolina.


The Endowment’s Child Care program area identifies vulnerable children by factors that influence child abuse and neglect, such as a mother’s age, education and family income. These risk factors often accompany a teen pregnancy.

“Preventing child abuse and neglect is a key aspect of our work, and teen pregnancy is a predictor of difficult situations,” says Rhett Mabry, president of the Endowment . “The more our Trustees focused on prevention and early intervention, the more it seemed that we should be involved in this arena. We saw this as another step upstream.”

In South Carolina, a $237,800 grant from the Endowment in 2011 supported the Collective Impact Project, which looked at the myriad of teen pregnancy prevention efforts in the state to see what’s working and to pinpoint gaps in services.

With the grant, the South Carolina Campaign to Prevent Teen Pregnancy had the resources it needed to address two unresolved questions: How does the state maximize and measure the collective impact of dollars that have been leveraged to address teen pregnancy? And how does South Carolina sustain this continued progress for the long-term?

The research was developed into a report, “Accelerating Progress: A Road Map for Achieving Further Reductions in Teen Pregnancy.”

In 2014, the Endowment introduced a special program around teen pregnancy prevention that is focusing on three prevention strategies:

  • Building capacity of select statewide providers to promote prevention efforts
  • Creating access to Long Acting Reversible Contraceptives (LARCs) for older teens
  • Supporting integration of effective practices into schools and community organizations

One project is underway in North Carolina. The Center for Supportive Schools received a two-year grant from the Endowment to start the Teen Pregnancy Education Program (Teen PEP) in six high schools in the state. Teen PEP is a peer-led model where high school juniors and seniors serve as health educations for ninth grade students.

Also in North Carolina, a $150,000 grant from the Endowment in 2016 is supporting SHIFT NC’s assessment and planning in Mecklenburg County.

In South Carolina, a larger-scale project in Darlington County is showing promise. Darlington County has the 16th highest teen birth rate in the state (36.8 per 1,000) and has been consistently above the national level. On nearly every measure, teen pregnancy and births greatly impact the county.

The South Carolina Campaign to Prevent Teen Pregnancy has partnered with a lead local agency, Darlington County First Steps, to establish a comprehensive, community-wide teen pregnancy prevention initiative. The county public school system, local clinics and hospitals, and community organizations are participating.

With initial funding from the Endowment of nearly $62,000, the goal is to implement a multi-pronged approach to combat teen pregnancy. In 2015, a $780,000 grant was approved to implement evidence-based programs, increase access to effective contraception, and improve outreach to parents and youth.


Area of Work

  • Prevention and early intervention for at-risk children

Program Area

  • Child & Family Well-Being

Grantmaking Status

Areas of Work

  • Prevention and early intervention for at-risk children

    To equip children and families with skills to ensure that children reach developmental milestones to lead successful lives.

  • Out-of-home care for youth

    To drive child welfare systems toward greater accountability for child well-being.

  • Quality and safety of health care

    Improving the quality and safety of health care delivery

  • Access to health care

    Improving health by increasing access to comprehensive care

  • Prevention

    Expanding programs to promote health and prevent disease

  • Academic excellence

    Enhancing academic excellence through program and campus development

  • Educational access and success

    Increasing educational access and supporting a learning environment that promotes achievement

  • Campus and community engagement

    Promoting a culture of service, collaboration and engagement among schools and communities

  • Rural church development

    Building the infrastructure and capacity of United Methodist churches to enhance ministry and mission

  • Clergy leadership

    Strengthening United Methodist churches by improving the quality and effectiveness of church leadership

  • Congregational outreach

    Engaging United Methodist congregations in programs that serve their communities